Department of Obstetrics and Gynecology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey.
Department of Obstetrics and Gynecology, Health Sciences University Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey.
Ginekol Pol. 2020;91(3):117-122. doi: 10.5603/GP.2020.0027.
This study aimed to evaluate data on early diagnosis and therapeutic management of rudimentary horn pregnancy (RHP).
Patients diagnosed with RHP at a tertiary center between for two periods of 2008-2012 and 2013-2018 were analysed retrospectively. We obtained information of patients from hospital electronic archive registration system. Data on demographic characteristics, clinical presentation, gestational age at presentation, presenting symptoms, diagnostic methods, and therapeutic management were noted and analysed by descriptive statistical method. Demographic datas, the complaint of patient's admission to hospital, history of cesarean section, preliminary diagnosis and intraoperative diagnosis were compared between periods of 2008-2012 and 2013-2018.
A total of 14 RHP patients were included. Eight (57.1%) of these patients were diagnosed between 2008-2012 (Group 1), whereas six patients (42.9%) were diagnosed between 2013-2018 (Group 2). Rudimentary horn was non-communicating in 13 patients (92.8%). Communicated form was observed in 1 patient in group 1. RHP was diagnosed on the left side in nine patients (64.2%). Six of these patients were observed in group 1 and 3 were in group 2. The pre-rupture diagnosis was made in 10 (71.4%) patients. Six (100%) of 10 patients were in group 2. In addition, in group 1, four patients (50%) experienced intraoperative RHP rupture. RHP was diagnosed before rupture in 2 (33.3%) patients in group 2.
It is an indication of advanced ultrasonographic technology as well as increased carefulness on the physician side and raised alertness on the patient side that today both RHP and preoperative rupture of RHP are less frequent. Still, further awareness is required among physicians of the necessity of excision of a rudimentary horn that is detected at the time of C-section.
本研究旨在评估早期诊断和治疗残角子宫妊娠(RHP)的数据。
回顾性分析 2008-2012 年和 2013-2018 年在一家三级中心诊断为 RHP 的患者。我们从医院电子档案登记系统获取患者信息。记录并分析人口统计学特征、临床表现、就诊时的孕龄、就诊症状、诊断方法和治疗管理等数据,并采用描述性统计方法进行分析。比较 2008-2012 年和 2013-2018 年期间的人口统计学数据、患者入院时的主诉、剖宫产史、初步诊断和术中诊断。
共纳入 14 例 RHP 患者。其中 8 例(57.1%)患者于 2008-2012 年期间诊断(第 1 组),6 例(42.9%)患者于 2013-2018 年期间诊断(第 2 组)。13 例(92.8%)残角子宫为非交通型。第 1 组中有 1 例为交通型。9 例(64.2%)患者的 RHP 位于左侧,其中 6 例在第 1 组,3 例在第 2 组。10 例(71.4%)患者在破裂前做出诊断,其中 10 例(100%)在第 2 组。此外,第 1 组有 4 例(50%)患者术中发生 RHP 破裂,第 2 组中有 2 例(33.3%)患者在破裂前做出诊断。
这表明超声技术的进步,以及医生方面的谨慎性提高和患者方面的警惕性提高,使得现在 RHP 和术前 RHP 破裂的发生率都较低。然而,医生仍然需要进一步意识到在剖宫产时发现残角子宫时切除残角子宫的必要性。